Carolina Podiatry Clinic Llc

LBN: Carolina Podiatry Clinic Llc
Carolina Podiatry Clinic Llc is an health care organization with primary practice located at 2502 Broad St , Camden SC 29020. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is the primary health care specialty. Carolina Podiatry Clinic Llc can be contacted via phone (803) 425-5510, or through Ksor, John via phone (864) 494-0534.

Contact Information

Primary practice address
2502 Broad St Camden SC 29020
Phone: (803) 425-5510
Fax: (803) 432-4776
Website:
Map and Directions
Authorized official contact:
Name: Ksor, John Doctor of Podiatric Medicine (DPM)
Phone: (864) 494-0534

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 563 South Carolina
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X DE3794 South Carolina
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 6460510001 South Carolina

Profile Details

NPI number 1932421385
LBN Legal business name Carolina Podiatry Clinic Llc
DBA Doing business as
Authorized official Ksor, John Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2010
Last updated Aug 17th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932421385 NPPES
South Carolina MEDICAID GP9894
South Carolina Other DQ3852

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